| Douglas County Public Health Services Group, Inc. | |
|
804 N Highway 5 Mansfield MO 65704-7301 | |
| (417) 924-8809 | |
| (417) 924-8870 |
| Full Name | Douglas County Public Health Services Group, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 804 N Highway 5, Mansfield, Missouri |
| Authorized Official Name and Position | Jennifer Heinlein (HRO) |
| Authorized Official Contact | 4176834831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas County Public Health Services Group, Inc. 504 Nw 10th Ave. Po Box 1359 Ava MO 65608 Ph: (417) 683-4831 | Douglas County Public Health Services Group, Inc. 804 N Highway 5 Mansfield MO 65704-7301 Ph: (417) 924-8809 |
| NPI Number | 1568774503 |
|---|---|
| Provider Enumeration Date | 07/07/2010 |
| Last Update Date | 01/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568774503 | NPI | - | NPPES |
| 26-1881 | Other | MEDICARE PART A | |
| 505408526 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2010015973 (Missouri) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Max E. Harkey, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 S. Lincoln Ave, Mansfield, MO 65704 Phone: 417-924-3262 |